Pregnancy and an abnormal Pap test

Pregnancy does not appear to increase the progression of abnormal cervical cell changes. The presence of abnormal cervical cell changes or HPV does not affect the outcome of the pregnancy. Close monitoring is needed so that you and your health professional can make the best treatment decisions at each stage of the pregnancy.

An abnormal Pap test may be evaluated further with colposcopy. Colposcopy is a safe test during pregnancy.

If colposcopy shows normal tissue, then a repeat Pap test or colposcopy may be done later, depending on the type of abnormalities reported on the first Pap test.

If colposcopy confirms abnormal tissue areas, a cervical biopsy may be done to diagnose the abnormal tissue. This level of testing is also done to make sure cervical cancer, which is rare, is not present. If a cervical biopsy is needed during pregnancy, it does not usually cause problems with the pregnancy though the risk of bleeding is greater after the first trimester. Minor cell changes should continue to be monitored during the pregnancy and after delivery. Some studies show that many minor cell changes return to normal after delivery.

Moderate to severe cell changes indicated by an abnormal Pap test are always evaluated by colposcopy, and possibly cervical biopsy, to diagnose the abnormal tissue and to make sure invasive cervical cancer is not present. Follow-up Pap tests and colposcopy may be done for the rest of the pregnancy to monitor the progression of the cell changes. Moderate to severe changes can be monitored closely, and treatment can wait until after delivery. On rare occasions. a procedure called a cone biopsy is needed to rule out cancer.

Treatment of invasive cervical cancer must be done as soon as possible. It is more difficult to manage because of the concern for the outcome of both the woman and her pregnancy. Treatment will be managed by a team of health professionals specializing in cancer and high-risk pregnancies.